In order to measure the level of progress toward achieving national immunization goals outlined in the "Healthy People 2010. priority areas of Immunization and Infectious Diseases, and to protect people from vaccine preventable diseases, the United States government conducts population-based vaccination coverage surveys, including the National Health Interview Survey, the Behavioral Risk Factor Surveillance System and the National Immunization Survey-Adult. However, the accuracy and validity of a patient. Self-report is subject to lapses due to time and memory as well as other factors, and may not always be correct. Also, many adults obtain immunizations at a variety of venues, over many years, and through multiple providers. Many of the vaccinations, such as tetanus/diphtheria, pneumococcal polysaccharide vaccine, and the hepatitis A and hepatitis B series, may have been administered 10-15 years before the survey is answered, thereby increasing the likelihood of inaccurate self-report. Finally, a number of patients may provide inaccurate self reports for fear of affirming risky behaviors linked to certain vaccinations. The lack of data on reporting accuracy impacts ability to interpret immunization rates resulting in potentially faulty policy decisions based on inadequate and inaccurate data. The purpose of the proposed study is to comprehensively assess the validity and accuracy of self-reported adult vaccination status in the U.S. for the nine most common adult vaccines, and in addition, describe how validity may vary by age and race/ethnicity. The proposed research will conduct 10,600 telephone interviews of patients seen at HealthPartners clinics, including both members and non-members, to obtain their immunization status for nine adult vaccinations: trivalent inactivated influenza vaccine (TIV), tetanus/diphtheria (Td), pneumococcal polysaccharide vaccine (PPV), hepatitis A (HepA) and hepatitis B (HepB), live, attenuated influenza vaccine (LAIV), tetanus/diphtheria/pertussis (Tdap), Zoster (shingles) and human papillomavirus (HPV). HealthPartners clinics maintain complete and accurate vaccination histories recorded for each respondent in electronic medical records that will serve as the gold standard. We will calculate sensitivity, specificity, positive predictive value, negative predictive value, percent false positive (1-specificity), percent false negative (1- sensitivity) and net bias for self report vaccination status for each of the vaccines in each of the age and racial/ethnic subgroups, weighted to population representation. The results of this study have the potential to guide the development of future policies, resources and activities related to monitoring adult vaccination coverage in the United States.